For Healthcare Professionals

Gastrointestinal

Gastrointestinal side effects have frequently included nausea and vomiting (13% to 30%) and constipation. Bowel obstruction, ileus, chalk like taste, perforation of the gastrointestinal tract and subsequent charcoal (the active ingredient contained in Liqui-Char) peritoneum, and black colored stools have also been reported.[Ref]

A young woman developed a surgically acute abdomen following orogastric lavage and charcoal administration. Laparotomy revealed charcoal throughout the peritoneum. Complications included peritonitis, adhesions, abscess formation, persistent peritoneal charcoal deposits, oophorectomy, and small bowel resection.

A case report has described charcoal bezoar and small bowel obstruction following administration of 30 to 60 g of activated charcoal via nasogastric tube every 4 to 6 hours for 5 days.

In a study of 275 patients, 18 years old or younger, 20.4% (56/275) experienced vomiting within < 1 to 120 minutes (mean of 10 minutes) following enteral administration of 1 g/kg (no more than 50 g) of activated charcoal for acute poison ingestion. The following risk factors for vomiting were identified: nausea, a vomiting occurrence prior to charcoal ingestion, presence of signs or symptoms of poisoning (exclusive of nausea &/or vomiting), age greater than 12 years, administration by nasogastric or orogastric tube, and ingestion of emetogenic drug or chemical.

Bowel obstruction and ileus have occurred with multiple-dose administration.

Although charcoal is tasteless, it adheres to the surfaces of the mouth and tongue, producing a chalk like taste that can be unpalatable.[Ref]

Metabolic

Metabolic side effects have included hypernatremia, hypermagnesemia. electrolyte abnormalities, dehydration, and shock.[Ref]

Metabolic side effects occur primarily when sorbitol is combined with charcoal. Multiple-dose activated charcoal has been associated with hypernatremia and hypermagnesemia.[Ref]

Respiratory

Respiratory side effects have included bronchiolitis obliterans, empyema, and Adult Respiratory Distress Syndrome.[Ref]

Bronchiolitis obliterans and empyema have occurred due to charcoal aspiration following emesis.

Accidental administration of charcoal directly into the lungs has resulted in Adult Respiratory Distress Syndrome.[Ref]

Professional resources

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